Using an inhaler

Almost 25 million people in the United States have asthma. That number includes over 4.6 million children under the age of 18.

A small medical device called an inhaler is a common way to treat respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD), which cause symptoms like shortness of breath, chest pain or wheezing.

However, inhaler misuse is a persistent issue. Up to 92% of asthmatic patients incorrectly use inhalers.

Following proper inhaler technique helps ensure that the medication reaches the lungs.

Let’s take a look at how to use an inhaler properly, the types of inhalers available and how to troubleshoot common inhaler problems. 

In this article:

What is an inhaler?

An inhaler is a device used for giving inhaled medications (medicines that are breathed in through the nose or mouth).

Inhaled therapy is extremely important for COPD and asthma treatment, and correctly delivering the inhaled medication to the lungs is crucial for treatment efficacy and safety. However, studies have shown that most patients do not use their inhaler correctly. Proper instruction and education can help address these issues. 

Types of inhalers

Many people may not realize that there are different types of inhalers. While each handheld inhaler delivers medicine through inhalation, there are key differences in inhaler types:

• Metered-dose inhalers (MDIs). MDIs deliver a specific, or metered, dose of medication. To use an MDI, press the canister and inhale simultaneously.
• Dry powder inhalers (DPIs). DPIs are designed with a chamber that holds the powdered medication. A person pulls the medicine into their lungs by taking a deep, fast breath.
• Soft mist inhalers (SMIs). Soft mist inhalers dispense medication more slowly than MDIs and DPIs, allowing more of the medication to get into the lungs.

Inhalers versus nebulizers

Inhalers and nebulizers both deliver medicine to the lungs. However, these two medical devices work in different ways. A nebulizer machine sprays a liquid mist of medicine through a mouthpiece or mask and is often used for people who can’t use an inhaler.

Nebulizers can take a long time to use — often 5 to -10 minutes per treatment — whereas an inhaler only takes 5-10 seconds per inhalation. For young children, the elderly or people who have severe asthma or COPD attacks, nebulizers might be necessary since inhalers may not be appropriate.

Who needs to use an inhaler?

People with chronic conditions that affect their breathing, like asthma, lung diseases or COPD, most commonly use inhalers. People of any age or gender may need to take an inhaled medication. 

Common uses of an inhaler

Some asthma patients (those with milder cases, for instance) might only need inhaled medications when they are actively having an asthma attack. Inhaled short-acting beta2-agonists (SABAs) act as quick-relief medicines to help open up the airways when needed. Other people with asthma may need to take inhaled medications on a daily basis to help prevent asthma symptoms and attacks. 

People with COPD are commonly prescribed long-acting bronchodilator inhalers to use on a daily basis to relax the airways and short-acting bronchodilators during flare-ups.

Preparations before using an inhaler

Before using an inhaler, there are a few preparations people can make to help ensure they are properly administering the medicine:

Check the expiration date. An expired inhaler could be less effective or potentially unsafe.

Make sure the inhaler is clean. Examine the mouthpiece for dust, debris or blockages. If the mouthpiece is removable, rinse it with warm water and let it air dry completely before reattaching. Always be sure to check the cleaning instructions found within the product's instructions.

Carefully read the dosage instructions. Not all inhalers are alike, so make sure to follow the manufacturer’s instructions for the specific inhaler that has been prescribed. 

Prime the inhaler if necessary (upon first use or if the inhaler hasn’t been used for a while). Typically, this involves shaking the inhaler and then spraying it into the air, but follow the manufacturer’s instructions for priming. 

Tracking medication usage

Some inhalers indicate how many doses are left. If a specific product doesn’t have this function, a person should keep a log of each time the inhaler is used to ensure they don’t run out of medicine unexpectedly. They can also use a smartphone app to track doses and set reminders for refills.

Recognizing and managing side effects

Some inhaled medications can have side effects, particularly for those on a high dose for a long time. For example, corticosteroid inhalers might cause side effects such as a sore throat, a hoarse voice or oral thrush (a fungal infection in the mouth). Rinsing their mouth after using an inhaler can help prevent side effects like these. 

Consistent timing and routine

When prescribed a daily inhaler, they generally should be used at the same time each day. This helps maintain a consistent level of medication in the system and also incorporates inhaler use into the routine, helping someone remember and adhere to their treatment plan.

Common mistakes to avoid

It can take a few uses to get comfortable using a new inhaler. Common mistakes when using an inhaler include not waiting long enough between puffs, someone not holding their breath long enough or forgetting to shake the inhaler before use.

Incorrect inhalation speed

Breathing in too early or too late can cause some of the medication to stick in the mouth or throat instead of going all the way to the lungs. A spacer can help if someone struggles to breathe at the correct time when using a metered-dose inhaler. Always use products as directed and speak to a health care provider about issues or additional support that may be appropriate. 

Not shaking the inhaler

Metered-dose inhalers need to be shaken before usage so the medicine mixes correctly before exiting the inhaler. Read the inhaler’s instructions on shaking before use.

Inhaling multiple puffs at once

Generally, people should only inhale one puff of the inhaled medication at a time. If the prescription calls for multiple puffs at once, follow the instructions on waiting a certain amount of time in between. 

Not holding the breath long enough

Ten seconds is typically the ideal amount of time someone should hold their breath after taking in a puff of their inhaler. This allows the medicine to settle into their lungs rather than being immediately expelled. People should consult the instructions on how long to hold their breath based on the specific product information and always use products as directed by manufacturer instructions. 

Troubleshooting inhaler problems

Read through these common inhaler problems.

Dealing with a blocked nozzle

If an inhaler’s nozzle (the part that sprays the medication through the mouthpiece) is blocked, it should be cleaned as directed on the package insert.

Recognizing an empty inhaler

If an inhaler isn’t working, it might be out of medication. Some inhalers have a dose counter that displays a number showing how many doses are left. If there isn’t a dose counter, consider noting how often it’s used to estimate when it might run out.

Final thoughts on how to use an inhaler

Using an inhaler correctly is crucial for getting the medication. If someone is having continued issues with their inhaler or their respiratory symptoms are uncontrolled despite correct usage of prescribed inhalers, it’s important to make an appointment with a health care provider to discuss their concerns. 

This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.